Fibromyalgiepatiënten horen vaak de woorden “Je ziet er zo goed uit. Hoe kun je ziek zijn? “Of misschien zijn de ongevoelige woorden” fibromyalgie zit helemaal in je hoofd “. Lopend en recent onderzoek; valideert echter de realiteit van deze onzichtbare ziekte. Deze informatie stelt mensen met fibromyalgie en andere vergelijkbare onzichtbare ziektes in staat om ongetwijfeld verder te gaan en validatie te vinden voor hun complexe ziektes. Nog belangrijker, inzicht in recent onderzoek helpt bij het geven van richting en identificeert natuurlijke keuzes voor een gezond pijnmanagement met fibromyalgie.
Wat is een ontsteking?
Ontsteking is onderdeel van het genezingsproces van het lichaam. Zonder ontsteking zouden infecties en wonden niet genezen. Maar een ontsteking kan ook schadelijk zijn. Er zijn twee soorten ontstekingen, acuut en chronisch. Acute ontsteking treedt plotseling op na een verwonding of infectie. Het presenteert klassieke symptomen zoals zwelling, roodheid en pijn.
Acute ontsteking is tijdelijk, van enkele dagen tot enkele weken, afhankelijk van de oorsprong van de ontsteking. Chronische ontsteking is een langdurige ontsteking die maanden en jaren aanhoudt. Het gaat langzaam en zet het podium voor chronische ziekten. Hartziekten, auto-immuunziekten, neurologische ziekten, diabetes, kanker, Alzheimer, artritis en vele andere aandoeningen zijn gekoppeld aan chronische ontsteking.
Onderzoeksteams vinden wijdverspreide ontstekingen in de hersenen van fibromyalgiepatiënten
PET-beeldvormingsonderzoeken laten een verhoogde gliale activering zien, correlatie met vermoeidheidsniveaus. Een studie heeft voor het eerst een wijdverspreide ontsteking in de hersenen van patiënten met de slecht begrepen aandoening genaamd fibromyalgie gedocumenteerd.
Een onderzoek door onderzoekers van het Massachusetts General Hospital (MGH) – samen met een team van het Karolinska Institutet in Zweden – heeft voor het eerst een uitgebreide ontsteking in de hersenen van patiënten met de slecht begrepen aandoening genaamd fibromyalgie gedocumenteerd. Hun rapport is online gepubliceerd in het tijdschrift Brain, Behavior and Immunity .
“We hebben geen goede behandelingsmogelijkheden voor fibromyalgie, dus het identificeren van een mogelijk behandelingsdoel kan leiden tot de ontwikkeling van innovatieve, effectievere therapieën”, zegt Marco Loggia, PhD, van het MGH-gebaseerde Martinos Center for Biomedical Imaging, co- senior auteur van het rapport. “En het vinden van objectieve neurochemische veranderingen in de hersenen van patiënten met fibromyalgie zou het aanhoudende stigma van veel patiënten moeten verminderen, vaak wordt verteld dat hun symptomen denkbeeldig zijn en er is niets echt mis met hen.”
Het huidige onderzoek levert bewijs van verhoogde TSPO-binding, gemeten met CPBR28 PET, bij patiënten met fibromyalgie (FM) in vergelijking met gezonde controles (HC). Deze marker van gliale activatie was verhoogd in verschillende hersengebieden die betrokken zijn bij FM-pathologie van eerdere neuroimaging-onderzoeken. We rapporteren ook positieve associaties tussen het TSPO PET-signaal in verschillende van deze regio’s en subjectieve beoordelingen van vermoeidheid, een van de meest voorkomende symptomen gemeld door FM-patiënten (Clauw, 2014, Wolfe et al., 2011). Onze observaties ondersteunen een rol voor neuroimmune / gliale activatie in FM-pathologie.
Deze resultaten komen overeen met een aantal klinische gegevens die wijzen op een mogelijke associatie tussen neuroinflammatie en FM. Verschillende studies van FM-patiënten toonden verhoogde CSF niveaus van moleculen die betrokken zijn bij neurogliale signalering, zoals fractalkine en IL-8.
Fibromyalgie en Neuroinflammation
Ontsteking is een steeds belangrijker onderwerp geworden bij fibromyalgie. Het is duidelijk dat “centrale sensitisatie” – een toename in pijngevoeligheid ontwikkeld door het centrale zenuwstelsel aanwezig is in fibromyalgie (en andere chronische pijnstoornissen). Pro-inflammatoire zenuwfactoren worden geproduceerd door een ontstekingsproces, die zenuwfactoren sturen de pijnproducerende zenuwen in een tizzy en kunnen de oorzaak zijn van die centrale sensitisatie.
Neuro-inflammatie is dan een belangrijke mogelijkheid bij FM, maar het meten ervan was niet eenvoudig. Pas recent zijn er hersenbeeldvormingstechnieken ontwikkeld die mogelijk de neuroinflammatie kunnen meten die aanwezig is in FM. Deze studie probeerde de kwestie van neuroinflammatie op een andere manier aan te pakken. De laatste tijd is er toegenomen belangstelling voor de verschillende cellen van de hersenen die een rol spelen bij ontsteking en overgevoeligheid.
Eén zo’n cel waarvan bekend is dat deze een centrale rol speelt in de ontstekingsreacties in de hersenen is microglia. De hersenen hebben een vrij dichte populatie van hen. Maar voordat we meer kijken naar de rol van microglia bij hersenontsteking en hyperreactie, laten we ons meer begrijpen over ontstekingen en de relatie tussen hersenaandoeningen en perifere ontstekingsziekten. Immers, FM wordt vaak geïnitieerd door een gezondheidstoestand die de perifere organen aantast.
Mechanisme van ontsteking
Ontsteking is een verdedigingsmechanisme. Als het lichaam eenmaal geconfronteerd is met een infecterend agens of lokaal trauma, wordt het herkend en praktisch opgegeten (infectiemiddel, puin, ander vreemd materiaal) door de cellen die macrofagen worden genoemd. Macrofagen spelen ook een centrale rol bij het initiëren van een immuunrespons en ze doen dit door cytokinen en chemokinen af te scheiden.
Chemokines zijn de boodschappers die andere soorten verdedigingscellen naar het gebied aantrekken, terwijl cytokines complexere boodschappers zijn die de informatie over de stress en aanval naar verschillende cellen en delen van het lichaam sturen. Kort na de initiële ontstekingsreactie treedt ziekte op, resulterend in verhoogde lichaamstemperatuur, pijn en verlies van interesse in alles rondom.
Het is een tijd waarin onze hersencentra in actie komen. Het zijn de specifieke centra in de hersenen die de lichaamstemperatuur verhogen om de microbiële groei te beheersen (toename van lichaamstemperatuur is een geregeld verdedigingsmechanisme). Onze hersenen proberen energie te besparen door ons te dwingen om te rusten, sociale interactie, fysieke activiteiten te verminderen.
We weten dat de hersenen, ongeacht de locatie van de ontstekingsreactie, een centrale rol spelen bij het beheersen van verschillende reacties. Het werpt de vraag op naar het mechanisme dat ten grondslag ligt aan de informatie-uitwisseling tussen het punt van ontsteking (dat vaak ver van de hersenen verwijderd is) en de hersenen. Dat gebeurt op twee manieren, ten eerste door de boodschappers die cytokines worden genoemd, en ten tweede door de input van de zenuwen
Behandeling om neurologische ontsteking te verminderen
We hebben al enkele bewijzen dat behandelingen die speciaal het ontstekingsniveau in de hersenen verlagen, de fibromyalgiesymptomen kunnen verminderen. Veel van wat we beschouwen als ontstekingsremmende medicijnen (zoals ibuprofen of andere niet-steroïde ontstekingsremmers) werkt niet goed bij hersenontsteking, maar er zijn enkele behandelingen die dit wel doen. Een lage dosis naltrexon (LDN) is het meest efficiënt, dit is een medicijn maar wordt vooral voorgeschreven door leveranciers van alternatieve medicijnen, omdat de meeste artsen in de westerse geneeskunde niet zo bekend zijn met het gebruik voor pijn.
Een opiaat-blokkerende medicatie staat bekend als Naltrexon en wordt voorgeschreven in hogere doses (50 mg) voor de behandeling van opiaat- en alcoholverslaving. LDN verlaagt ontsteking in het centrale zenuwstelsel wanneer het wordt gebruikt bij zeer lage doses (doseringsbereik van 1-5 mg).
Er zijn specifieke receptoren op de immuuncellen in de hersenen die gliale cellen worden genoemd, LDN reageert daarop en vertelt hen om terug te gaan naar de slaapstand en stoppen met het vrijgeven van ontstekingschemicaliën. In twee onderzoeken aan de Stanford University bleek LDN de fibromyalgiepijn aanzienlijk te verminderen en ook de hypersensiviteit van pijn te verminderen.
Kruidenbehandeling om ontstekingen te behandelen
Kurkuma: Al honderden jaren wordt dit gele kruid gebruikt als een ontstekingsremmer in de ayurvedische geneeskunde. Het actieve bestanddeel is een chemische stof genaamd curcumine, waarvan onderzoek heeft aangetoond dat het ontstekingsremmende effecten heeft in de hersenen.
Groene thee: een stof genaamd EGCG (-) – epigallocatechin-3-gallate is “sterk defensief tegen ontsteking, oxidatieve schade en celdood” in de hersenen. Het wordt gewonnen uit groene thee.
Kruisbloemige groenten: Sulforafaan is een extract van broccoli en het beschermt tegen hersenontsteking en vermindert de schade aan neuronen.
Ontstekingsremmende supplementen zijn onder meer:
- >>> omega-3 vetzuren
- >>> kurkuma >>> gember
- >>> coQ10
- >>> rhodiola rosea
Veel artsen bevelen ontstekingsremmende voeding aan voor ontstekingsaandoeningen, maar we hebben er niet genoeg onderzoek naar gedaan. Mensen beginnen vaak met een strikt beperkt dieet, omdat de ontstekingsactiveringen van iedereen niet hetzelfde zijn en vervolgens in één soort voedsel tegelijk worden toegevoegd om te controleren welk voedsel problematisch is.
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